1.Medication Because of the easy application and obvious effect, it is the preferred measure for the treatment of this disease. Most of the antihistamines, steroid hormones and mast cell stabilizers, etc., can be taken orally and local spraying, injection methods.
① Antihistamines are mostly used as H1 receptor antagonists, which are convenient to use and work quickly, and are the first-line drugs for the treatment of this disease. At present, the first generation of antihistamines paracetamol, sebacrine, bromfenamine; the second generation of antihistamines cetirizine, loratadine, etc. are commonly used in clinical practice. They have different degrees of central inhibitory effects and need to be used with caution. They are weak in relieving nasal congestion and effective in treating nasal itching, sneezing and increased secretion. In recent years, the intranasal topical antihistamine nystatin has been applied in clinical practice.
②Glucocorticoids have significant inhibitory effects on mast cells, basophils and mucosal inflammatory reflections, increase vascular tone and reduce their permeability, and have anti-allergic effects. However, long-term systemic use of glucocorticosteroids can produce toxic effects, therefore, there are not many opportunities for systemic use, and they are only used for a few seriously ill patients, and the course of treatment usually does not exceed two weeks. Intranasal glucocorticoid preparations are mostly used in clinical practice. These corticosteroids are characterized by strong local effects on the nasal mucosa but low systemic bioavailability, and systemic side effects can be minimized by using them according to the recommended dosage. At present, the glucocorticoid nasal sprays widely used in clinical practice include beclomethasone dipropionate, budesonide, tretinoin, fluticasone propionate, and mometasone furoate.
All of the above drugs are symptomatic treatment and are useful in relieving symptoms such as nasal congestion, runny nose, sneezing and itchy eyes, especially for patients with severe systemic symptoms. However, they require long-term use and rebound from discontinuation, with varying degrees of systemic adverse effects. Due to the reduction of drug potency after long-term use, systemic adverse reactions increase, and the clinical effect is also significantly reduced, which tends to make patients lose confidence in treatment.
2, desensitization therapy The use of desensitization therapy for the treatment of allergic rhinitis is to gradually increase the amount of injections made of allergens, repeatedly injected to patients several times, in order to improve the patient’s tolerance to allergens. However, the difficulty in finding the allergen makes the course of treatment too long, resulting in the clinical efficacy is not very significant.
3, immunotherapy Immunotherapy induces clinical and immune tolerance, has long-term effects, and can prevent the development of allergic diseases. Specific immunotherapy is commonly administered by subcutaneous injection and sublingual administration. The course of treatment is divided into a dose accumulation phase and a dose maintenance phase, with a total duration of not less than 2 years. Indications are mainly for patients with allergic rhinitis who have failed to respond to conventional drug therapy. Immunotherapy may have local and systemic adverse effects and has limitations in its use.
4.Surgical treatment Surgical treatment mainly adopts radiofrequency ablation therapy, cryotherapy, laser, microwave and surgical treatment.
①The most used clinical treatment is laser, microwave and radiofrequency ablation therapy. Laser treatment can be carried out under mucosal surface anesthesia, and patients feel light pain. The positioning is accurate, and the scope and depth can be controlled according to the condition. Microwave and radiofrequency ablation treatments must be combined with local injection anesthesia because of their significant pain. In addition, physical therapy may have sequelae such as nasal dryness, nasal mucosa atrophy and post-nasal flow. Except for the above-mentioned undesirable factors, physiotherapy is a relatively safe and effective adjuvant treatment for AR.
②Cryotherapy:It is rarely used clinically because of its difficult to grasp the scope and degree of treatment.
③Surgical treatment has certain therapeutic effect in the short term, but because of its difficulty, patients suffer more, and the surgery has certain risk, often with partial recurrence 1 year after surgery. Surgery cannot directly change the immune status of AR patients, so it is mostly used as an adjuvant treatment.